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Leave your son’s foreskin alone

by John V. Geisheker, J.D., LL.M.
Executive Director, General CounselIn my capacity as the Executive Director of Doctors Opposing Circumcision, an international physicians’ non-profit, I field around three anguished complaints each week from parents of intact (not circumcised) boys whose foreskins were forcibly retracted by ignorant medical practitioners. Premature, forcible, foreskin retraction (PFFR) is a much more painful, serious, and potentially permanent injury than most parents imagine. It is also epidemic in English-language medicine (though apparently not elsewhere). I speculate that only one in 1,000 cases in N. America comes to our attention. Indeed many parents have no idea their child was injured or why. That might mean as many as 150,000 cases in the USA each year, but no one knows for sure.

Here is a typical incoming email. (For reasons of HIPAA protection of our parents, this complaint is a composite, details changed, but it is very typical).

“Dear Mr. Geisheker,

I have read on a mothering website that you handle complaints about retracting the foreskin of little boys. We kept our boy, Ethan, now six months old, intact because we know circumcision is unnecessary, painful and risky. Last week during a routine doctor visit, and before I could stop him, our pediatrician, Dr. ‘Paul,’ peeled my son Ethan’s foreskin back all the way. It happened so fast there was nothing I could do.

“Ethan screamed instantly, cried for hours, and has been restless and fussy ever since. There are now small circles, like cracks, around his foreskin, which ooze blood. His whole penis is red and swollen. Ethan is now unusually fussy as soon as his diaper is wet, and we think it must sting when he urinates. He screams when we change him or the diaper touches his penis. It just breaks my heart to hear him. He had no problems at all before this doctor visit.”

“Dr. Paul told us that we must pull Ethan’s foreskin back this way every day or at least at every bath, to prevent what he called ‘adhesions’ and to clean out the smegma that builds up there. He said that if we don’t, our boy will need to be circumcised for sure.”

“Is all this necessary? I can’t believe you need to hurt a boy to keep him clean. It makes no sense to me and I am very angry at what happened to Ethan. He was a very happy baby before this.”

What happened to ‘Ethan’ in this composite anecdote (my three cases each week all have similar heart-breaking details) is an unmitigated, inexcusable disgrace, indefensible medical malpractice, and a clinically unnecessary (and illegal) injury to the child. ‘Mom of Ethan’ has exactly the right instincts, and with good reason.

Forced retraction is only rarely defensible. Inguinal hernia, undescended testicle, hydrocele, and varicocele can all be addressed without forcible retraction. The penis should be repositioned for any necessary intervention with sterile tape, not by inserted hemostat. Catheterization can be done by ‘feel,’ without retraction. Only in the instance of significant hypospadias or epispadias (congenital malposition of the urethral opening) might retraction be necessary and, even then, only if it is unavoidable collateral damage for which there should be specific follow-up care.

[D.O.C. follows up all such complaints with a footnoted 10-page letter to the physician or nurse, detailing the correct medical protocol, and if the parents agree, a formal complaint to their state licensing authority we are only too happy to file.]

This post is the beginning of a much longer, more detailed article on the D. O. C. website by John Geisheker.

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12 thoughts on “Leave your son’s foreskin alone”

Thank you, Gloria, for sharing this sad, but informative article. If only everyone knew just how many infections occurred because of misinformed doctors trying to forcibly retract. This is an issue that everyone should know about. Especially anyone caring for a child.

The level of ignorance of basic human anatomy and function in American medicine is astounding. I personally know medical professionals who think circumcision is a prophylaxis for penile cancer. My intact son was born in 1994 and even back then we knew better than to forcefully retract. Human males evolved just fine by leaving it alone and letting nature do its thing.

Premature retraction is medical malpractice and should be prosecuted to the full extent of the law.

That is completely unacceptable practice for a doctor. The parents should sue for malpractice and causing harm to their son’s penis. If it does happen, I think if you leave the foreskin back in place and treat the scar tissue and infection with creams, he should be ok. Just don’t ever tear it back! It is frightening how ignorant doctors are. Causing pain in the name of hygiene is absurd and goes against every rational instinct we have.

I agree that this should be prosecuted to the fullest extent of the law. It is inexcusable that doctors would do this quickly, before the parents even have a chance to object. Parents go through enough of a minefield to keep their children intact in the first place; and what a shame that they have worry that someone will, without warning or permission, injure their child’s genitals at any time.

What an awful story! I’ve decided I don’t care if I look slightly paranoid, I educate anyone who might diaper my son or give him medical care about NOT retracting his foreskin… my friend who’s been a nurse for 20 years didn’t know that you weren’t supposed to do this, so I really don’t trust that anybody knows how to properly care for an intact boy anymore!

It is amazing that doctors are not required to learn accepted medical practice. And that they are not getting sued over this more frequently. That would get their attention and I bet this would fade into the past quickly.

My wife left to Utah on a family trip and took my son to the doctor. When they returned I noticed that the base of penis was red as well as the tip. She just confessed that the doctor retracted and told her to retract his penis to clean it often. I am furious! I don’t know what type of damage has occurred.

I’m intact and never once as a child had to retract, it wasn’t until I was a teenager and curious about my body that it happened.

What steps should I take or what should I look out for?
If damage was occurred is this malpractice?